Pregnancy Flashcards
(127 cards)
1
Q
enlarged uterus initially caused by
A
elevated estrogen and progesterone
2
Q
enlarged uterus later caused by
A
mechanical pressure after first trimetser
3
Q
by what point does the uterus reach the abdominal cavity
A
12 weeks
4
Q
uterine weight increases by
A
10 fold
5
Q
uterine capacity increases by
A
500-1000 x
6
Q
cardiovascular changes seen by
A
5 weeks
7
Q
what happens to heart? 7 things
A
enlarges, shifts upward and to left; axis changes; increase HR; increase CO; decreased vascular resistance; splitting 1st heart sound(systolic murmur)
8
Q
upper respiratory changes? five things
A
SOB, increased secretions, swollen mucus membranes, increased epistaxis, chronic cold symptoms
9
Q
what impact does progesterone have in GI system?
A
relaxes sphincters, leads to GERD
10
Q
bowel changes
A
slower transit time leads to constipation
11
Q
N/V treatmetn
A
B6 and unisom
12
Q
zofran SE
A
heart defects and cleft palate
13
Q
kidney changes
A
enlarge
14
Q
ureter changes
A
dilate
15
Q
what’s not uncommon to see with kidneys?
A
hydronephrosis (just watch for infection)
16
Q
bladder changes
A
increases vascularity and decreases capcity
17
Q
UA changes
A
proteinuria (not concerning unless seen with HTN)
18
Q
breast changes
A
increased vascularity; heaviness and pain (6 weeks)
19
Q
nipple and areola changes
A
hyperpigmented, erectile, Montogomery tubercle more prominent and raised (8-20 weeks)
20
Q
when does colostrum secretion begin?
A
16 weeks
21
Q
derm changes
A
linea nigra; chloasma; striae
22
Q
mask of pregnancy
A
cholasma
23
Q
MSK changes
A
increased lumbar lordosis; widening of pubic symphysis; loosening of SI and pubic joints
24
Q
triglyceride changes
A
increase
25
total cholesterol changes
increase
26
LDL changes
increase
27
pancreas changes
fasting hypoglycemia; postprandial hyperglycemia
28
thyroid changes
increase in size; slight decrease in TSH
29
fetus dependent on maternal thyroid hormone until
12 weeks
30
adrenal changes
increased cortisol; increased aldosterone; ACTH
31
pituitary changes
increase in size; susceptible to bleeding; prolactin and oxytocin increase
32
dental changes
tooth sensitivity; bleeding gums; increased susceptibility to bacteria
33
severe gum disease is linked to
preterm labor and LBW
34
diagnose pregnancy with
serume or urine assay for beta-human chorionic gonadotropin
35
may detect pregnancy as early as X from missed period
4-7 days
36
US can confirm pregnancy as early as
5 weeks
37
Fetal heart rate at
6 weeks
38
GTPAL stands for
gravidity, parity (term, preterm, abortions, living children)
39
term pregnancy
37-42
40
preterm pregnancy
20-36
41
abortions
spontaneous or induced; before 20 weeks
42
no delivery
nulliparous
43
first delivery
primaparous
44
previously delivered
multiparous
45
EDD
Add 1 year year to first day of last menstrual period, subtract three months; add 7 days
46
average duration
280 days or 40 weeks
47
x cm per week in fundal height
1 cm
48
just above pubic symphysis
12 weeks
49
midway between pubis and umbilicus
14-16 weeks
50
level of umbilicus
20-22 weeks
51
height equal to gestation age in weeks by
22-38 weeks
52
2-3 cm below xiphoid process
38-40 weeks
53
Chadwick sign
cervix, vagina, and vulva bluish color due to increased vascularity
54
Goodell's sign
softening and cyanosis of cervix after 4 weeks
55
effacement
thinning of cervix
56
cervix will gradually thin to
only a few mm
57
which comes first in the primavera? effacement or dilation
effacement
58
dilation
opening of the cervical canal
59
Fetal heart rate at
11-12 weeks
60
fetal movement appreciated by mother at
16-20 weeks
61
fetal movement times per hour
10 times in 1 hour to 10 times per 12 hours
62
start monitoring fetal movement at
34-36 weeks
63
Leopold Maneuvers: A
fetal pole--fetal lie; longitudinal or transverse
64
Leopold Maneuvers: B
umbilical pole--small parts/big parts; which ways is back facing
65
Leopold Maneuvers: C
Pawlicks Grim--confirms cephalic
66
Leopold Maneuvers: D
pelvic group--attiude (what is presenting and how); attitude; head flexed or extended
67
station
relationship of the presenting part of the ischial spines of the mother's pelvis
68
Braxton Hicks begin as early as the
third month
69
how does the uterus position change?
more anteflexed during the first three months
70
bleeding in early pregnancy can mean
ectopic pregnancy
71
bleeding in late pregnancy can mean
abruptio placentae: separation of placenta from the site of uterine implantation before delivery
72
Initial pregnant visit at
6-8 weeks
73
no brush after
10 weeks
74
test for gestational diabetes at
24-28 weeks
75
initial glucose test
drink glucose; one hour later; test. <130-140 is normal
76
Follow-up glucose testing
fast overnight, then test blood sugar level. Then drink another higher concentration glucose drink. Check every hour for three hours. If at least two are higher, then you have gestational diabetes.
77
A prior child weighing over x pounds then you might consider earlier glucose testing?
9 lbs
78
Rectus abdominal muscles separate
diastasis recti
79
umbilicus changes
flattens or protrudes
80
gallbladder changes
becomes distended, decreased emptying time and change in tone
81
what type of stones are you higher risk for?
gallstones (second and third trimesters)
82
dilation of the ureter is greater on the?
right side
83
ureter changes in shape
elongate and form single and double curves which can lead to urinary statis
84
renal function is most efficient if the individual
lies in the lateral recumbent position
85
renal changes can last up to
3-4 months after delivery
86
trigone changes
deepening and widening which may lead to microhematuria
87
colon location changes
displaced laterally upward and posterior
88
colon changes
peristaltic activity decreases; water absorption increases --> bowel sounds diminished, constipation and flatus common
89
appendix position changes
upward and laterally
90
immediately after delivery, the uterus is approximately the size of a
20 week pregnancy (palpable at umbilicus)
91
by end of first week post-partum, uterus is approximately size of
12 week pregnancy (palpable at pubic symphysis)
92
muscles of pelvic floor take how long to recover
6-7 weeks
93
protrusion of naval can indicate
umbilical hernia
94
ectopic pregnancy pain
lower quadrant, refers to shoulder; with rupture, agonizing
95
symptoms of ectopic pregnancy
hypogastric tenderness, symptoms of pregnancy, spotting, irregular menses, soft abdominal wall, mass on bimanual pelvic examination
96
symptoms of rupture ectopic pregnancy
shock, rigid abdominal wall, distension, Kehr, Cullen
97
Kehr sign
abdominal pain radiating to left shoulder
98
Cullen sign
ecchymosis around umbilicus
99
two signs of ectopic pregnancy
Kehr and Cullen
100
four pelvic joints
symphysis pubis; sacrococcygeal; two sacrioiliac joints
101
what hormones are responsible for softening of the pelvic cartilage and strengthening of the pelvic ligaments
relaxin and progesterone
102
pelvic joints separate and lead to what type of gait
waddle
103
symphysis pubis returns to prepregnancy state within
3-5 months
104
the cervical canal is obstructed with what after conception?
thick mucus protecting the infant from infection
105
what dislodges at beginning of labor?
"bloody show"
106
pH of vaginal secretions
acidic due to lactic acid
107
acidic vaginal pH can lead to
candida infection
108
cervix is located
midline
109
cervix consistency
softer
110
painful cervical movements can mean
ruptured tubal pregnancy
111
trimester length
slightly more than 13 weeks (3 months)
112
is early uterine enlargement symmetric?
maybe not
113
a variation of fundal height of x cm should be evaluated
2 cm
114
if uterus is smaller than expected, think:
intrauterine growth restriction
115
goodell occurs around
4-6 weeks
116
hegar
softening of the uterine isthmus
117
goodell
softening of the cervix
118
hegar at
6-8 weeks
119
mcdonald
fundus flexes easily on the cervix
120
mcdonald at
7-8 weeks
121
braun von fernwald
fullness and softening of teh fundus near the site of implantation
122
braun von fernwald at
7-8 weeks
123
piskacek
palpable lateral bulge or soft prominence of one uterine cornu
124
piskacek at
7-8 weeks
125
chadwich
bluish color of cervix, vagina, and vulva
126
chadwich at
8-12 weeks
127
shortening of the cervix (less than 29 mm midpregnancy) can mean
risk for preterm delivery
